Women who had mastectomies and reconstruction liked the looks but lacked tactile feeling - until now

Dr. Aldona Spiegel, director of Houston Methodist Hospital's Center for Breast Restoration, says the treatment to restore sensation has had good results. She hopes her study will make more women aware of the technique.

Photo By Â TODD SPOTH PHOTOGRAPHY, LLC

Dr. Aldona Spiegel poses for a portrait in her office, Friday, September 6, 2013 at the Methodist Hospital in Houston, Texas. (PHOTO BY TODD SPOTH)

Women who undergo a mastectomy and then breast reconstruction surgery typically lose most sensation across their chest, but a new technique being studied in Houston shows promise for restoring feeling.

The technique, developed by a Houston Methodist Hospital's plastic surgeon after a former patient was burned when she didn't realize that the water that spilled on her chest was steaming hot, could make routine the return of what is usually lost after the removal of breasts due to cancer or the threat of cancer.

"A lot of reconstruction patients comment that their breasts look great but lack sensation," says Dr. Aldona Spiegel, developer of the technique and director of Methodist's Center for Breast Restoration. "In fact, there's an option for women unhappy about that loss."

Spiegel says she hopes the research she's conducting provides evidence of the technique's effectiveness and helps put it "on the map." She has now used the technique, with much anecdotal success, in more than 200 breast reconstruction surgeries. She described it in a 2009 plastic surgery journal article.

An estimated 110,000 women a year opt to have a mastectomy, surgery to remove the entire breast (as opposed to a lumpectomy, where only part of the breast is removed).

Most mastectomies follow a diagnosis of invasive breast cancer, but an increasing number are done for preventive reasons - typically that the woman carries the genetic mutation that increases her chances of developing the disease.

Breast reconstruction has come a long way since the 1970s, when the only option for women who'd had a mastectomy was an external prosthesis, an artificial breast worn in the bra.

Today, women can choose between breast reconstruction using either implants (saline or silicone) or their own tissue taken from elsewhere in the body, usually the abdomen.

The majority of women choose implants - as much as 80 percent, according to some surveys - probably partly because many places don't offer microsurgery, which is necessary for tissue-based reconstruction. Spiegel says that the breakdown is closer to 50-50 if women are offered both alternatives.

There is no method to regain sensation if a woman has implant-only reconstruction.

Restoring sensation hasn't been a priority of breast reconstruction, even though patients link it to improved quality of life, according to Spiegel.

There were past attempts to regenerate a nerve microsurgeons considered a good candidate, but the difficulty accessing it and prolonged surgical time made the effort hard to justify.

Challenged by her former patient's burning episode, Spiegel began working with a nerve more conveniently located. In what only prolongs the surgery 15 minutes, she got positive results connecting the nerve around the same location where doctors microsurgically attach blood vessels.

"Women report a return in sensation as a result of this technique," says Spiegel. "Not to pre-mastectomy levels, but they do feel sensation in the reconstructed breast again."

In an attempt to quantify the benefit, Spiegel enlisted a device that measures the amount of pressure that must be applied to the breast before the patient feels something.

The device found that those who received the new technique required about 28 percent less pressure to feel a sensation in their chest than those who got the standard method.

Spiegel also noted as evidence of the technique's effectiveness that patients getting it need anesthesia for the nipple areola tattooing that marks the finishing touch to breast reconstruction.

Among Spiegel's grateful customers is Karen Holt, the second patient on whom Spiegel employed the new technique. She noticed sensation in her reconstructed breast two months after the surgery, when her oncologist's pressure on Holt's breast hurt.

"It seems like a miracle to me," says Holt, 61, a retired school administrator. "I can't see or feel a difference in my two breasts. It's a gift; it makes you feel like a whole woman again."

Spiegel warns that not everyone has such results - in most cases, it takes six to eight months for sensation to return, she says, and it's usually not the same as it was before. She also says the restoration of sensation isn't important to lots of women.

But she calls the new method very exciting for those women for whom it is important and says she hopes her study popularizes it.